Wendy is a new mom who made sure to go to all the classes given for expecting mothers. This included birthing, breastfeeding, and parenting classes. During one of the weekly parenting classes, her instructor was discussing placing the baby on their back when they go to sleep. The Back to Sleep campaign was instituted in 1994 by an aggregation of American Academy of Pediatrics (AAP), National Institute of Child Health and Development (NICHD), the Maternal and Child Health Bureau, and other SIDS organizations. Ever since the campaign was instituted, crib death or better known as Sudden Infant Death Syndrome (SIDS), declined significantly. Wendy followed this protocol and made sure to place her newborn, Cody, on his Back to Sleep.

After Cody’s second visit to the pediatrician, Wendy noticed that her baby had developed a flat spot on the side of his head. Be it that this was the baby’s second doctor visit they would not be seen until the baby was four months old. Since that was the case, she had to pay out of pocket to get her baby checked out again. At the visit, the pediatrician told her that Cody had a condition of plagiocephaly in tandem with the tightening of the neck muscles, called torticollis. This may explain as to why Cody would stubbornly refuse to turn his neck to the right side. He always would reposition his torso when needing to look in that direction. At this point, all Wendy focused on was to give her baby the correct therapy to get his head shape and neck back to normal.

Unfortunately, new mothers are not always taught the methods of preventing plagiocephaly and torticollis. Usually these classes focus on techniques of surviving through infancy and not petty exercises like Tummy Time. It’s much easier to place your baby Back to Sleep rather than spending a significant amount of time with your baby on the floor practicing neck exercises. On top of that, no mom wants to place their cute baby in a tackle hold to prevent them from moving as they gently bend the neck in the opposite direction. Often the baby could be shrieking during such torticollis therapy.

Will torticollis correct itself?

Most people find it hard to exercise to stay in shape and so do babies. It’s time consuming, the baby often finds it irritating, and it takes energy from both mom and baby. When parents find out that their baby has a certain condition, the one thing they always ask, “Will it correct itself on its own?”.

Each case of torticollis needs to be addressed on its own by a medical professional. Some types of torticollis are a congenital condition, occurring in the womb, while other types may occur after birth. At this point, it’s important to address the underlying issue which is that the sternocleidomastoid muscle is tight, causing the baby to lean to one side. When the baby needs to look at an object on the opposite side, they will often reposition their whole body to get a good view of what they need to look at. Babies typically would simply turn their neck without shifting their whole torso.

After verifying that the baby has torticollis, which is the tightening of the muscles in the neck, there is always a possibility of it correcting itself on its own. Perhaps the baby will get so frustrated and force themselves to use their neck, stretching out the tight sternocleidomastoid muscle (SMS). In such a scenario it very well may correct itself. Repetition of the neck exercise will release the tension on the tight SMS muscles. This is what torticollis therapy accomplishes by repeating similar exercise until the condition becomes obsolete.

Leaving torticollis untreated

While you may save yourself a little bit of time and money, infant torticollis may or may not resolve itself on its own. Leaving this condition untreated and not engaging your baby in torticollis treatment can lead to positional plagiocephaly. It’s the neck tension which leads to poor positioning habits. When the baby’s head is not positioned correctly, the weight shifts towards one side and results in the baby developing a flat spot. That might require your baby to be fitted with an orthotic helmet to relieve the pressure on the flat spot.

What are the right torticollis exercises?

Once determining that this is indeed baby torticollis, it’s important that parents learn the correct exercises. While some torticollis therapies are unpleasant for the baby, there are basic play activities which can be done, keeping the baby in a happy mood.

1) Floor seat exercises – During playtime when your baby is on the floor, have them sit upright in a floor seat which allows them to sit upright with their neck fully exposed. There are many seats, such as the Bumbo® which prop the baby up just enough, giving them the proper support to sit on their own. While they are in the seat, take a toy and have them follow it with their eyes as they try to grab it. The rotation of the neck will be fine until they reach a point where the stiffness prevents them from turning further. At this point, try to get the baby to begin using their neck muscles instead of repositioning their torso to view the object. Keep on repeating this exercise for as long as you and the baby can handle it. Please make sure to always have the baby sitting on the floor and never on an elevated surface. It’s easy for the baby to fall and severely hurt themselves.

2) Directing the face in the opposite direction – On a smooth surface, place the baby flat on its back and hold the right shoulder firmly. A strong hold is necessary in order to allow the baby not to squiggle out. Then take your left hand and place it on the opposite side of the baby’s face and gently push until the baby’s cheek is flat against the surface. Hold the baby’s head in place and count ten seconds and then release. At this point your baby is probably screaming on top of their lungs but this exercise forces the sternocleidomastoid muscles to be stretched. Then do the same to the other side and count for another ten seconds. It’s important to work out each side’s neck muscles in order to release the tension. After a few weeks of this exercise you should begin to see improvement in the way your baby holds their neck.

3) Torticollis stretches football hold – This might be more for the father but can be also done by the mother. Exactly the way a good NFL running back holds the football, with the outside panel of the ball pressed against their forearm and chest, this is how you should hold your baby during this exercise. The baby should be facing away from you against your chest and the rear-end should be situated above the elbow. The rest of your hand should be free and use the pointer finger to keep the shoulder down. Let the baby’s head rest in the crevice or cubital fossa, of your opposite elbow. As you push the shoulder down with the index finger of the hand with which you are holding the baby, the neck muscles should begin to stretch, releasing tension from the stiff SMS muscles. 

4) Torticollis massage techniques – In addition to the infant torticollis exercises above, it’s recommended to massage the muscles directly. Station yourself above the baby’s head and try and keep their shoulders down, exposing the neck area as much as possible. Then gently tilt the neck to the opposite side just enough to stretch out the neck muscle. Repeat this a couple of times throughout the day. Another massaging technique would be to keep the baby flat on their back and turn the baby’s head from side to side. Make sure that the baby’s back remains flat against the floor, keeping the body stable. If the body moves, you will miss the opportunity to stretch those stubborn SMS muscles. It’s always recommended that while holding the baby to work to gently massage the neck to relieve the stiffness.

Torticollis collars, pillows, and mattress for infants

There are many products on the market to help with muscular torticollis in newborns. They all are made to force the baby to use the opposite side of the neck, engaging the tight SMS muscles. These may be used in conjunction with torticollis therapy, but don’t think that purchasing a product from Amazon will extend the shorter neck muscle. This is not to say that they don’t provide any benefit, it’s just not a proactive approach to treating torticollis.  

Get educated on infant torticollis exercises and spend more time playing with your baby. During playtime try and force your baby to use the side of the neck which is tight. Just one torticollis workout is more beneficial then a nap on a torticollis mattress. Stay focused on stretching out the stubborn neck muscles, and before you know it your baby will hold its head proud and tall.